| NPI | 1285074302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 130124) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 116531) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2023-03-16 |