NPI | 1700250305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: LMFT138782) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF89278) |
106H00000X Marriage & Family Therapist (Licence: CA AMFT89278) | |
106H00000X Marriage & Family Therapist (Licence: CA 138782) | |
Enumeration Date | 2015-11-19 |
Last Update Date | 2023-05-10 |