| NPI | 1124142633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT47903) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 47903) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-06-17 |