| NPI | 1437469103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 134099) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 120144) |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2024-03-15 |