| NPI | 1518151919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 114136) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF74877) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2021-08-27 |