| NPI | 1124664826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT129106) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT97599) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2022-10-11 |