NPI | 1801363973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 131687) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 102587) |
Enumeration Date | 2018-10-26 |
Last Update Date | 2022-03-10 |