| NPI | 1255613535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-15395) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT96000) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2024-06-04 |