| NPI | 1225172315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT142599) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT103450) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2026-05-04 |