| NPI | 1346791423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 112228) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF95796) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2022-12-21 |