| NPI | 1396031670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: HI 631) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 84529) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2023-11-29 |