| 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) |
| 106H00000X Marriage & Family Therapist (Licence: TN 2552) | |
| 106H00000X Marriage & Family Therapist (Licence: UT 14072848-3902) | |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2024-09-24 |