| NPI | 1912287277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 1511P-S) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2021-06-22 |