| NPI | 1780011437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT96210) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2023-12-21 |