| NPI | 1184768913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 46226) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 14247058-3902) |
| 106H00000X Marriage & Family Therapist (Licence: TX 206148) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2025-10-01 |