| NPI | 1538385653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC18089) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 18089) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2021-12-30 |