| NPI | 1912215724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 51738) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2015-02-19 |