| NPI | 1699099382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 74267) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: CA 88232) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2022-10-28 |