| NPI | 1477707271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 131348) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF89146) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2024-07-02 |