| NPI | 1407394877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT0002412) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT139683) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2023-08-03 |