| NPI | 1043588577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT83968) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF68411) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2021-10-13 |