NPI | 1922671346 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 143854) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 128520) |
Enumeration Date | 2021-07-22 |
Last Update Date | 2024-11-04 |