| NPI | 1396390985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 132923) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 106H00000X Marriage & Family Therapist (Licence: CA 119995) | |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2022-06-01 |