| NPI | 1457865081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF97571) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT119705) |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2020-07-16 |