| NPI | 1154674299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT126140) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 90611) |
| 106H00000X Marriage & Family Therapist (Licence: CA 126140) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2021-12-21 |