| NPI | 1841648185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 113359) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 106H00000X Marriage & Family Therapist (Licence: TX 204222) | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2024-10-12 |