| NPI | 1134670862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ID LMFT-7471) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID LAMFT-7049) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2022-11-21 |