| NPI | 1568757789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 103208) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF 68467) |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF 68467) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2018-01-04 |