NPI | 1124156211 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC31915) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT31915) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2010-10-18 |