| NPI | 1386731669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 31971) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN 401143) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2014-07-18 |