| NPI | 1992243877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 110344) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 7948) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2021-12-23 |