| NPI | 1235664335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT123730) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF96899) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2023-12-13 |