NPI | 1013939313 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS13942) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC19448) |
Enumeration Date | 2006-07-24 |
Last Update Date | 2010-01-27 |