| NPI | 1952567356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 113211) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 65857) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2019-09-19 |