| NPI | 1215113758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 91279) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 80990) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2023-05-25 |