| NPI | 1649513664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT105250) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF73883) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2018-03-28 |