| NPI | 1316146749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 33982) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT85437) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2023-06-08 |