NPI | 1821301128 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 92768) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 69915) |
Enumeration Date | 2010-07-15 |
Last Update Date | 2020-06-16 |