| NPI | 1427494459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 93602) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35002161A) |
| 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-15825) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2024-03-27 |