| NPI | 1245966621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 144077) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2026-07-02 |