| NPI | 1205046315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 106365) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 83715) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-08-30 |