| NPI | 1306263546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT108525) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2019-08-23 |