| NPI | 1245506146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC50968) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-06-3068) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2012-03-26 |