| NPI | 1295456416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 124792) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 139746) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2023-06-01 |