| NPI | 1588863047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT80213) |
| 106H00000X Marriage & Family Therapist (Licence: CA 57349) | |
| Enumeration Date | 2007-07-15 |
| Last Update Date | 2022-11-07 |