| NPI | 1285092411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 107258) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF87490) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2018-09-05 |