| NPI | 1922017573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35001484A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO 646) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2008-10-17 |