| NPI | 1558689786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT82576) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF62731) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2019-12-09 |