| NPI | 1265161921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT142956) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2023-11-21 |