NPI | 1740738293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 124927) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 94299) |
Enumeration Date | 2016-09-13 |
Last Update Date | 2021-04-12 |