| NPI | 1639554421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT106018) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2021-05-24 |