NPI | 1487725735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 5081) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 9264) |
Enumeration Date | 2006-11-10 |
Last Update Date | 2007-07-18 |