| NPI | 1225503469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT146022) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT115221) |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2026-05-18 |