| NPI | 1821137084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR A0805006) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR A0305005) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-07-22 |