| NPI | 1841933173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 152820) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 135116) |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2025-03-31 |