| NPI | 1467505040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC37476) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 6278252-3902) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-07-09 |