NPI | 1326404492 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 129834) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 77045) |
Enumeration Date | 2016-01-05 |
Last Update Date | 2023-04-27 |