NPI | 1598950107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 111899) |
Additional Taxonomies | 101Y00000X Counselor |
106H00000X Marriage & Family Therapist (Licence: CA 63057) | |
106H00000X Marriage & Family Therapist (Licence: CA 92081) | |
Enumeration Date | 2007-09-07 |
Last Update Date | 2021-07-03 |