| NPI | 1871762864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 36751) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA mfc36751) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2024-09-17 |