| NPI | 1922408004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: DC 000169) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 1525) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-08-26 |