| NPI | 1356650428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 7701594-3904) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 123171) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2025-10-17 |