| NPI | 1043464985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 92408) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF84509) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2024-08-31 |