| NPI | 1750443743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT81180) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 43219) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-12-01 |