| NPI | 1558439935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV #01166) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC46820) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2026-07-14 |