| NPI | 1740356419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 44055) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 44055) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2011-10-17 |