NPI | 1184842171 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT 45692) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 201356) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2024-10-30 |