NPI | 1043717416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT130550) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2018-04-11 |
Last Update Date | 2022-10-10 |