| NPI | 1285959593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 101319) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 76768) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2018-02-13 |