| NPI | 1417285107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 49666) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 45092) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2017-01-18 |