| NPI | 1912592403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT159938) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT133924) | |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2026-01-09 |