| NPI | 1619206398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT31240) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT31240) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2023-07-10 |