| NPI | 1194351296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 133300) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 117318) |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2023-05-23 |