| NPI | 1770837478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OK 1369) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 114818) |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF69202) | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2020-11-19 |