| NPI | 1699188854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 104467) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF87134) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2018-02-12 |