| NPI | 1417079310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA mfc46133) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 44300) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2026-07-15 |