| NPI | 1316123904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF54054) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 54054) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2012-10-05 |