NPI | 1386761856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 81237) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 81327) |
106H00000X Marriage & Family Therapist (Licence: CA 42316) | |
Enumeration Date | 2007-03-22 |
Last Update Date | 2024-06-12 |