| NPI | 1184866519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF54414) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2013-02-05 |