| NPI | 1073130316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 161160) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2026-02-18 |