| NPI | 1558918839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 124641) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166.001589) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-01-19 |