| NPI | 1093198442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 96514) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 83466) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2022-11-16 |