| NPI | 1992141378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AR A1303034) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR A1303009) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |