| NPI | 1891944914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 51907) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 204323) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2024-05-20 |