| NPI | 1801214531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT111151) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF71824) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2022-07-25 |