| NPI | 1851592406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT108137) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 95407) |
| 106H00000X Marriage & Family Therapist (Licence: CA 64626) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2026-03-11 |