| NPI | 1881821049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 01173) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV MI0137) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2017-01-25 |