| NPI | 1649787953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC130897) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 101370) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2022-02-01 |