| NPI | 1285188581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 133987) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 93817) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2023-04-18 |