| NPI | 1366743346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 82938) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 203128) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2019-02-03 |