| NPI | 1437811387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 139105) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT123893) |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2023-04-15 |