| NPI | 1780736314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 14138) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA my14138) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2009-04-03 |