| NPI | 1447512991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT131688) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist (Licence: CA imf97667) | |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT97667) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2024-12-21 |