| NPI | 1457803025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT107307) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF95550) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2018-07-24 |