| NPI | 1407911878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC29757) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 646) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2024-06-11 |