NPI | 1841502531 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT86120) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2010-07-09 |
Last Update Date | 2022-01-03 |