| NPI | 1851798383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 101607) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 76995) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2018-05-16 |