| NPI | 1215707690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 145728) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2024-03-25 |