| NPI | 1306195169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 142067) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 78012) |
| 163WC1500X Registered Nurse, Community Health (Licence: CA 78012) | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2025-06-05 |