| NPI | 1437513157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 100116) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 75798) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2018-11-07 |