| NPI | 1992473490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 126480) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL TPMF344) |
| 106H00000X Marriage & Family Therapist (Licence: TX 204172) | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2023-11-02 |