NPI | 1760711501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 122091) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 12091) |
Enumeration Date | 2009-12-07 |
Last Update Date | 2021-03-23 |