| NPI | 1396963369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MO 2010042181) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 46301) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2011-08-10 |