| NPI | 1689156895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 138413) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2024-07-04 |