| NPI | 1477953834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 119985) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 88906) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2023-03-30 |