| NPI | 1467578567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC45808) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 261) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2017-08-17 |