| NPI | 1225756216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-16517) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LAMFT-10777) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2026-05-12 |