| NPI | 1831529973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT 83961) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF 72876) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2015-05-01 |