| NPI | 1922424274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: 108456) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF79146) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2022-10-24 |