| NPI | 1144741463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 118711) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2024-03-11 |