| NPI | 1285809814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT52087) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 56359) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2021-04-12 |