NPI | 1588030522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 105525) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF#87741) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2020-06-17 |