| NPI | 1578154662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: LA PLM1488) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171M00000X Case Manager/Care Coordinator (Licence: LA PLM1488) | |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2023-12-12 |