NPI | 1326179466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 87914) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 43011) |
Enumeration Date | 2007-03-08 |
Last Update Date | 2018-05-07 |