| NPI | 1114075330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 129217) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF88779) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-03-21 |