NPI | 1417452194 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT130943) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF102444) |
Enumeration Date | 2018-03-26 |
Last Update Date | 2022-12-13 |