NPI | 1518213719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT82937) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2012-07-25 |
Last Update Date | 2022-07-21 |