| NPI | 1659593192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC51224) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 51224) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-03-21 |