| NPI | 1952575144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 44488) |
| Additional Taxonomies | 251S00000X (Licence: CA MFC 44488) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |