| NPI | 1083805998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT52687) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 57818) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2015-12-01 |