| NPI | 1184858607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 46335) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID 6801) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2023-09-25 |