| NPI | 1922693266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT124456) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 124456) |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-07-23 |