NPI | 1710029350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 49565) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 51089) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2024-09-24 |