| NPI | 1386232320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 134793) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2022-10-21 |