| NPI | 1023674249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC51178) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI MFT-535) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-05-13 |