| NPI | 1063547917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 49156) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 43630) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2016-08-29 |