| NPI | 1063563245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 106759) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2025-04-15 |