| NPI | 1922230036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT86118) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF64683) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2015-04-16 |