| NPI | 1750683066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AL LMFT345) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2025-04-17 |