| NPI | 1942583927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT114587) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT93332) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2019-08-21 |