| NPI | 1306333133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ 15683) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LAMFT-10584) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2023-09-29 |