| NPI | 1013422732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 123814) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 101524) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2023-07-31 |