| NPI | 1538507694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT88817) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T2481) |
| 106H00000X Marriage & Family Therapist (Licence: WA 60599604) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2025-08-05 |