| NPI | 1982827846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 28235) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT28235) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2022-05-04 |