| NPI | 1437453115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 91081) |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2021-05-03 |