| NPI | 1285131094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 1130018) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI 718) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2026-03-23 |