| NPI | 1487030862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 136036) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT86176) |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT125194) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2023-01-10 |