| NPI | 1689847477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 46982) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 42833) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2021-08-19 |