| NPI | 1639392095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 50442) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 51714) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-02-11 |