| NPI | 1962548289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF74604) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 52907) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2015-07-02 |