| NPI | 1447424031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC30166) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA mfc30166) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2013-12-03 |