| NPI | 1598075111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 87660) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA Imf 64400) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2022-12-22 |