NPI | 1598896730 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT47585) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 202583) |
Enumeration Date | 2007-03-08 |
Last Update Date | 2024-02-22 |