| NPI | 1386318103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT151402) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2024-12-04 |