| NPI | 1891229688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA lmft119399) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF94609) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2021-05-25 |