| NPI | 1194912774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT13314) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF64991) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2021-01-26 |