| NPI | 1538375159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 47106) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC47106) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-02-11 |