| NPI | 1417334228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 129815) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 85515) |
| 106H00000X Marriage & Family Therapist (Licence: CA 125322) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2022-03-28 |