| NPI | 1801314299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 151936) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT110749) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2024-12-17 |