| NPI | 1093932634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT86824) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 86824) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2022-10-25 |