| NPI | 1497072938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 83364) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT83364) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2018-04-11 |