| NPI | 1831590371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 116291) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFTI95702) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2021-12-01 |