| NPI | 1083744676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 45831) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 201683) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2011-08-17 |