| NPI | 1396881165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 51701) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 52345) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2012-07-12 |