| NPI | 1447732292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT108507) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-19-35979) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2025-12-18 |