| NPI | 1588294987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 141550) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 117384) |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2023-09-21 |