NPI | 1336633841 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 103540) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CA 103540) |
Enumeration Date | 2018-06-18 |
Last Update Date | 2020-05-18 |