NPI | 1699143636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 88845) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3955) |
Enumeration Date | 2015-09-08 |
Last Update Date | 2024-08-08 |