| NPI | 1952580276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 104928) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF50440) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2023-02-09 |