| NPI | 1831428697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 2502) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV 01395) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2024-01-16 |