| NPI | 1811710148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 151277) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 137851) |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2025-02-03 |