| NPI | 1689860470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 106528) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFTI 62836) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2023-05-18 |