NPI | 1851926448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 106321) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 145062) |
Enumeration Date | 2020-03-04 |
Last Update Date | 2024-07-15 |