| NPI | 1417150087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001441) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT44578) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2020-08-19 |