NPI | 1225172315 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT103450) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF67686) |
Enumeration Date | 2007-02-20 |
Last Update Date | 2022-11-04 |