| NPI | 1376088112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT139577) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT104273) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2024-06-12 |