| NPI | 1295915957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 41279) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT 2102) |
| 106H00000X Marriage & Family Therapist (Licence: CO 269) | |
| Enumeration Date | 2007-11-10 |
| Last Update Date | 2009-07-22 |