| NPI | 1538334248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 38931) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI 112) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2024-10-10 |