| NPI | 1760859938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 111448) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2025-01-23 |