NPI | 1447600085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT119605) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF91033) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2021-08-04 |