| NPI | 1306388376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT129926) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT107048) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 129926) | |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2022-01-27 |