| NPI | 1447597505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 150775) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 109551) |
| 106H00000X Marriage & Family Therapist (Licence: CA 73296) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2024-10-28 |