| NPI | 1881375988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 5082) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV MI4251) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2025-07-22 |