| NPI | 1801201595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 35848) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 35848) |
| Enumeration Date | 2014-06-22 |
| Last Update Date | 2022-08-17 |