| NPI | 1881054351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFTI88734) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA PCCI2239) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-02-26 |