| NPI | 1285072843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 102014) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 77727) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2017-09-21 |