| NPI | 1235478710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 92603) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 73495) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2021-08-25 |