| NPI | 1386898732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT53265) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 58160) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2021-02-23 |