| NPI | 1104313527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT133660) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT113676) | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2022-07-12 |