| NPI | 1336494202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 111745) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 71399) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2025-09-09 |