| NPI | 1629307582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT86071) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 00284652) |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2025-07-15 |