| NPI | 1073730826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 125505) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 93125) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2021-11-09 |