| NPI | 1184454613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT147846) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 225400000X Rehabilitation Practitioner (Licence: CA AMFT147846) | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-09 |