| NPI | 1740840396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT125206) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT97966) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2024-08-05 |