| NPI | 1174946404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT129315) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 91496) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2024-10-17 |