NPI | 1780058131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 105283) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 89979) |
Enumeration Date | 2015-11-23 |
Last Update Date | 2021-07-01 |