| NPI | 1942695655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT111814) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF85209) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2021-02-08 |