| NPI | 1144652256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT114484) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF97076) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2019-10-02 |