| NPI | 1013320001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 144731) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 112004) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2024-02-02 |