| NPI | 1194064295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT102699) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF77870) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2019-03-11 |