NPI | 1154874915 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 115650) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF87443) |
Enumeration Date | 2016-07-28 |
Last Update Date | 2019-09-30 |