| NPI | 1285359968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 4167-R) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-15594) |
| 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001545) | |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2022-10-05 |