| NPI | 1699929976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 33038) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA MFT 33038) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2018-06-25 |