| NPI | 1356360812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT36493) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT36493) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-08-25 |