NPI | 1740761675 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135430) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT107557) |
Enumeration Date | 2018-08-28 |
Last Update Date | 2022-11-29 |