| NPI | 1497303655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 133200) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 106972) |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT106972) | |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2023-06-21 |