| NPI | 1346489077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 61796) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2016-10-26 |