| NPI | 1386761856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 81237) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 81327) |
| 106H00000X Marriage & Family Therapist (Licence: CA 42316) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-06-12 |