| NPI | 1285419887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 155228) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 130182) |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2025-05-20 |