| NPI | 1942603436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT134783) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2023-01-12 |