| NPI | 1699333138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT105081) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC4872) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2021-04-27 |