| NPI | 1740820935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT136078) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT114036) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2023-12-12 |