| NPI | 1700250305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: LMFT138782) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF89278) |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT89278) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 138782) | |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2023-05-10 |