| NPI | 1184166878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 136535) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 93910) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2023-01-24 |