| NPI | 1144543406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT 25176) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: CA MFT 25176) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2010-03-01 |