| NPI | 1346449113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC50682) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2011-11-15 |