| NPI | 1851926448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 106321) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 145062) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2024-07-15 |