| NPI | 1407924087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 51322) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2025-02-28 |