| NPI | 1851945810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 127359) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist (Licence: CA 116953) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 116953) | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2023-02-15 |