| NPI | 1821286071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 204225) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT81719) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2023-08-07 |