| NPI | 1114384724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 70654) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-04-26 |