NPI | 1194351296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 133300) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 117318) |
Enumeration Date | 2020-03-20 |
Last Update Date | 2023-05-23 |