| NPI | 1578773826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 45242) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 45262) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-05-09 |