| NPI | 1801429360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT154355) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2025-06-09 |