| NPI | 1669695599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 50841) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA B8238202) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2013-08-02 |