NPI | 1255764627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 98495) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2013-08-20 |
Last Update Date | 2018-07-23 |