NPI | 1346649167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT101248) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF82127) |
Enumeration Date | 2014-08-18 |
Last Update Date | 2021-03-16 |