| NPI | 1285333252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 146784) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO MFTC.0014494) |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2024-05-14 |