| NPI | 1154540714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT111561) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 75042) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-04-04 |