| NPI | 1346648458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT121271) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT89233) |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2022-09-14 |