NPI | 1740300318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 47303) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 46392) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2024-06-10 |