| NPI | 1609980234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT94162) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 41861) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-05-02 |