| NPI | 1245902113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT149518) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT128165) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2025-08-25 |