| NPI | 1760029334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT137150) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3353) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2023-10-18 |