| NPI | 1912213331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC53477) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 63696) |
| 106H00000X Marriage & Family Therapist (Licence: CA LMFT53477) | |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2021-03-31 |