| NPI | 1962536490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT 50073) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 50073) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-03-28 |