| NPI | 1235515305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT96993) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF# 77622) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2024-09-10 |