| NPI | 1356542153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT80362) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 40930) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2016-03-21 |