| NPI | 1740908946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 147962) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 115257) |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2024-10-12 |