NPI | 1265500193 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 62230) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 89431) |
106H00000X Marriage & Family Therapist (Licence: CA 44695) | |
Enumeration Date | 2006-11-30 |
Last Update Date | 2020-10-02 |