| NPI | 1295972354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: HI 581) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 46708) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2020-06-02 |