NPI | 1205043320 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 89909) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 2679) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2015-11-24 |