NPI | 1861844532 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 111632) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 89541) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2021-04-26 |