| NPI | 1306234612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT107842) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF#76396) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2021-10-12 |