| NPI | 1366709875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 85741) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV 5331-R) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2026-08-06 |