| NPI | 1710796586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT155693) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 172V00000X Community Health Worker | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-07-16 |