NPI | 1922693266 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT124456) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 124456) |
Enumeration Date | 2021-03-09 |
Last Update Date | 2021-07-23 |