| NPI | 1053906347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT130948) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT114582) |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2023-03-17 |