| NPI | 1265978662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT106936) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 106936) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2023-04-18 |