NPI | 1043828320 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT151057) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT131546) |
Enumeration Date | 2020-07-22 |
Last Update Date | 2024-11-06 |