NPI | 1952575144 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 44488) |
Additional Taxonomies | 251S00000X (Licence: CA MFC 44488) |
Enumeration Date | 2008-04-17 |
Last Update Date | 2008-04-17 |