| NPI | 1184914020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA LMFT1545) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 84815) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2024-12-06 |