| NPI | 1932344876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001674) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IA 00176) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2024-07-16 |