| NPI | 1083036099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT115475) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF90205) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2019-10-01 |