| NPI | 1942657119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT128310) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2023-04-04 |