| NPI | 1255623336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT110969) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-15553) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2025-07-11 |