| NPI | 1992166466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 114170) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ 10353) |
| 106H00000X Marriage & Family Therapist (Licence: WA LF 60645169) | |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2023-05-26 |