| NPI | 1396324075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 113829) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T2445) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2025-12-25 |