| NPI | 1730332784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA MFC 35275) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2012-08-08 |