| NPI | 1922615186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT111368) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2025-01-31 |