| NPI | 1619020476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 0001363) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC #44953) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2024-09-03 |