| NPI | 1154839447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 141763) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 111891) |
| Enumeration Date | 2018-01-20 |
| Last Update Date | 2023-11-02 |