| NPI | 1447742846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT116932) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2022-01-25 |