| NPI | 1275412835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0002899) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 151364) |
| Enumeration Date | 2025-08-28 |
| Last Update Date | 2025-08-28 |