| NPI | 1811161417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT15477) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT51826) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC 51826) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2022-07-29 |