| NPI | 1720126436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT34961) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 34961) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2021-12-21 |