| NPI | 1962879122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT96974) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF79358) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2020-07-30 |