NPI | 1285131094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 1130018) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF102303) |
Enumeration Date | 2018-04-09 |
Last Update Date | 2020-05-01 |