| NPI | 1265845382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: HI 822) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2023-03-09 |