| NPI | 1073849204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 110667) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 102360) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2023-09-18 |