| NPI | 1922344662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 94912) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 67758) |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2024-03-06 |