| NPI | 1063969145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT145491) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT108889) |
| 106H00000X Marriage & Family Therapist (Licence: CA 108889) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2024-03-07 |