NPI | 1023767084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 142837) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2022-03-18 |
Last Update Date | 2025-01-23 |