| NPI | 1134457633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT98173) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166.001493) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2025-09-16 |