| NPI | 1891098281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 20086) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: CA LEP 1342) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |