| NPI | 1336278571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT27527) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717002554) |
| 106H00000X Marriage & Family Therapist (Licence: NM CMF0222221) | |
| 106H00000X Marriage & Family Therapist (Licence: MD LCM1193) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2026-07-15 |