| NPI | 1801635206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT142916) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA APCC15133) |
| 133N00000X Nutritionist | |
| Enumeration Date | 2024-05-23 |
| Last Update Date | 2024-05-23 |