| NPI | 1215296231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT101214) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA LMFT101214) |
| 106H00000X Marriage & Family Therapist (Licence: CA MLFT101214) | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2020-09-08 |