| NPI | 1548590938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135806) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF101502) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2022-11-23 |