| NPI | 1609235761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT105036) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF84216) |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT84216) | |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2018-04-12 |