NPI | 1720436660 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT137724) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 109273) |
Enumeration Date | 2016-06-01 |
Last Update Date | 2023-04-05 |