| NPI | 1538408018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 87664) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF72990) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2015-08-06 |