| NPI | 1467830851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 125046) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2023-07-03 |