| NPI | 1255912671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LMFT84287) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA LMFT84287) |
| 101YM0800X Counselor, Mental Health | |
| 102L00000X Psychoanalyst (Licence: CA LMFT84287) | |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2022-02-11 |