| NPI | 1073644704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC51186) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 46136) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2016-09-02 |