| NPI | 1891345310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT121564) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 114201) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2023-03-07 |