| NPI | 1992089361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT154890) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 225400000X Rehabilitation Practitioner | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2025-05-19 |