| NPI | 1588977003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC80610) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2015-07-09 |