| NPI | 1801363973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 131687) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 102587) |
| Enumeration Date | 2018-10-26 |
| Last Update Date | 2022-03-10 |