| NPI | 1164026787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT155954) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT122401) |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2025-06-30 |