| NPI | 1215376884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT110095) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF81727) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2018-11-06 |