| NPI | 1275885113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 117278) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 76826) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2020-09-08 |