| NPI | 1366687162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT129228) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: CA IMF58728) | |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF 83871) | |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2023-06-15 |