| NPI | 1720436660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT137724) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 109273) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2023-04-05 |