| NPI | 1629593090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 141412) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF111425) | |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2024-02-14 |