| NPI | 1275389975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 145585) |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-05-06 |