| NPI | 1528723202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS LMFT-03325) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS LMFT-03325-T) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2023-01-25 |