| NPI | 1053469460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 43923) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA LPCC56) |
| 171100000X Acupuncturist (Licence: CA 18322) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2021-01-07 |