| NPI | 1871131672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 145472) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT117676) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2024-03-07 |