| NPI | 1407181779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 93288) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFTI 70990) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2017-02-16 |