| NPI | 1386049625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 99185) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF81146) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2019-11-09 |