| NPI | 1346538790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 111784) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF74303) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2023-03-21 |