| NPI | 1851805626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT117211) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF91276) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2023-02-22 |