| NPI | 1861686008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC44444) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: None) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-08-30 |