| NPI | 1063537348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 49146) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFTI 50937) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2015-03-23 |