NPI | 1548637168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 125236) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-08-31 |
Last Update Date | 2021-05-04 |