| NPI | 1124156211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC31915) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT31915) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2010-10-18 |