| NPI | 1932438488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 97687) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 61573) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2018-06-19 |