| NPI | 1447600085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT119605) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF91033) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2021-08-04 |