| NPI | 1659145191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 140697) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 15075) |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2024-03-28 |