| NPI | 1326387101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA mft23365) |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2013-02-13 |