| NPI | 1558590190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT48601) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 48601) |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2024-01-05 |