NPI | 1942439302 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: SC 4520) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 1309) |
Enumeration Date | 2009-07-07 |
Last Update Date | 2010-11-12 |