| NPI | 1649885617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT120650) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL TPMF620) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2022-10-12 |