| NPI | 1053734046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC38343) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA LPC208) |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2023-10-23 |