| NPI | 1518405513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 132581) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF91408) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2022-05-05 |