| NPI | 1285833962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 46086) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35002003A) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2022-01-03 |