| NPI | 1598367518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 143728) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 112564) |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2023-12-29 |