| NPI | 1154654069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 127648) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 88722) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2024-05-08 |