| NPI | 1457959116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 134771) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 120059) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2022-11-14 |