| NPI | 1780934414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 149921) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF79676) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2024-09-24 |