NPI | 1417085879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF67568) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2007-02-28 |
Last Update Date | 2016-03-22 |