| NPI | 1992011811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT88807) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF62082) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2023-08-24 |