| NPI | 1831037233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 158002) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 20572) |
| Enumeration Date | 2026-03-24 |
| Last Update Date | 2026-03-24 |