NPI | 1295270593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT115575) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF95768) |
Enumeration Date | 2016-12-22 |
Last Update Date | 2021-03-26 |