| NPI | 1164684627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 24971) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV 0615) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2008-06-26 |