NPI | 1457533630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT87428) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 45168) |
Enumeration Date | 2007-11-29 |
Last Update Date | 2019-03-11 |