| NPI | 1821423096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 94173) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF75698) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2016-07-29 |