| NPI | 1730404096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF 90801) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 62096) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2016-03-29 |