NPI | 1447597455 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF81700) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA IMF81700) |
Enumeration Date | 2013-01-10 |
Last Update Date | 2022-07-21 |