| NPI | 1801431325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 4922-R) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-15401) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2024-12-11 |