| NPI | 1528439957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT124809) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF93146) |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2021-05-20 |