| NPI | 1477029940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 123634) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 101082) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2023-02-14 |