| NPI | 1982896114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC39024) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 39024) |
| Enumeration Date | 2007-08-12 |
| Last Update Date | 2019-06-04 |