| NPI | 1497935969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 88859) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID 8862) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2026-03-20 |