NPI | 1699897678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT51617) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF51745) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2023-09-25 |