| NPI | 1871837120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT 87788) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 75210) |
| 106H00000X Marriage & Family Therapist (Licence: CA 87788) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2022-08-04 |