| NPI | 1164929436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT140054) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT104296) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2024-09-26 |