NPI | 1356972293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 117963) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2020-01-29 |
Last Update Date | 2024-08-13 |