NPI | 1053534255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT53689) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2007-04-10 |
Last Update Date | 2023-05-26 |