| NPI | 1205996469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001216) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 49501) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-01-03 |