| NPI | 1437205390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 106671) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA IMF76834) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2018-05-30 |