| NPI | 1780389049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 148550) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 174H00000X Health Educator | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2024-08-06 |