| NPI | 1205107547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT102611) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF68417) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2024-04-18 |