| NPI | 1265874374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ 15563) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 116064) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2023-06-13 |