| NPI | 1396273611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135153) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: 135153) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-10-11 |