| NPI | 1518097898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 106370) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 92074) |
| 106H00000X Marriage & Family Therapist (Licence: CA 62824) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2023-10-24 |