| NPI | 1801210166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT118795) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF78399) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2020-05-11 |