| NPI | 1861140949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT125742) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 125742) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2022-07-08 |