NPI | 1558689786 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT82576) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF62731) |
Enumeration Date | 2010-05-12 |
Last Update Date | 2019-12-09 |