| NPI | 1831401124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 84753) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: RI MFT00198) |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF 63132) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2025-06-03 |