| NPI | 1790979722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC39324) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| Enumeration Date | 2007-09-03 |
| Last Update Date | 2007-09-03 |