| NPI | 1861833089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 83959) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 73227) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2014-12-23 |