| NPI | 1134497472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT96817) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF70910) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2016-12-02 |