| NPI | 1497898902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN 1198) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA MFC 36210) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC 36210) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2015-08-31 |