NPI | 1265978662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT149562) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT106936) |
106H00000X Marriage & Family Therapist (Licence: CA 106936) | |
Enumeration Date | 2017-01-10 |
Last Update Date | 2024-09-26 |