NPI | 1114282035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 80303) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF63514) |
Enumeration Date | 2012-07-06 |
Last Update Date | 2016-07-17 |