| NPI | 1043828320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT151057) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT131546) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2024-11-06 |