| NPI | 1417433665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 1339908) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV 4706-R) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2026-03-23 |