| NPI | 1417452194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT130943) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF102444) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2022-12-13 |