| NPI | 1881175164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR F1610016) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR A1610129) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-08-24 |