| NPI | 1881153583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT135015) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT111192) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2022-10-19 |