NPI | 1770672362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 84277) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 49658) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2018-05-31 |