| NPI | 1528303948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 52527) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 52527) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2021-03-07 |