| NPI | 1326304759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF71035) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2015-06-19 |