NPI | 1922547785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 120597) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2017-02-13 |
Last Update Date | 2022-03-30 |