| NPI | 1932598133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 119501) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T2483) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2026-08-20 |