| NPI | 1295010023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 99187) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID 1971077) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2025-10-14 |