| NPI | 1093846776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC49157) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 47505) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2016-08-08 |