| NPI | 1407981624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 107412) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2021-10-14 |