NPI | 1083805998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT52687) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 57818) |
Enumeration Date | 2007-08-06 |
Last Update Date | 2015-12-01 |