| NPI | 1346300373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT #90726) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF48054) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2016-10-11 |