| NPI | 1376174466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT155847) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT117432) |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2025-10-07 |