| NPI | 1992052971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT99954) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3678) |
| 106H00000X Marriage & Family Therapist (Licence: CA 84657) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2020-12-27 |