| NPI | 1386814382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT49306) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF53646) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2010-12-08 |