NPI | 1487666186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 122872) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 1016) |
Enumeration Date | 2006-08-12 |
Last Update Date | 2021-05-24 |