| NPI | 1598129017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT128586) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-05-03 |