| NPI | 1275029910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT120374) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 120374) |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT108428) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2021-10-01 |