| NPI | 1740738293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 124927) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 94299) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2021-04-12 |