| NPI | 1629428693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF92744) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT110703) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2020-11-03 |