NPI | 1073730826 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 125505) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 93125) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2021-11-09 |