| NPI | 1851906549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 137863) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 121200) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2026-04-10 |