NPI | 1194863027 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 115534) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 7653) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2020-03-12 |