| NPI | 1124355979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT29420) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC29420) |
| Enumeration Date | 2009-11-14 |
| Last Update Date | 2018-07-26 |