| NPI | 1518103639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF 57399) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI MFT315) |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2012-07-27 |