| NPI | 1831639707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT120969) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA IMF98932) |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2022-08-23 |