| NPI | 1760804744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 39060) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NM CMF0184921) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2023-02-22 |