| NPI | 1154465821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 133088) |
| Additional Taxonomies | 104100000X Social Worker |
| 171M00000X Case Manager/Care Coordinator | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2024-09-10 |