| NPI | 1023553948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT149818) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2017-01-01 |
| Last Update Date | 2025-04-02 |