NPI | 1649513664 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT105250) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF73883) |
Enumeration Date | 2013-03-27 |
Last Update Date | 2018-03-28 |