NPI | 1003126780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT86808) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF63685) |
Enumeration Date | 2010-10-15 |
Last Update Date | 2015-05-26 |