| NPI | 1457401192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC21426) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MFC21426) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |