NPI | 1023894177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT134622) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA APCC12177) |
Enumeration Date | 2023-09-05 |
Last Update Date | 2023-09-05 |