NPI | 1477743235 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 50980) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA MFC 50980) |
Enumeration Date | 2007-07-27 |
Last Update Date | 2016-08-22 |