| NPI | 1134455710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 121222) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF72633) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2020-09-15 |