NPI | 1720412612 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 114081) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 74935) |
Enumeration Date | 2013-08-27 |
Last Update Date | 2024-07-17 |