| NPI | 1730547969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 111556) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2022-11-30 |