NPI | 1992007710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 113095) |
Additional Taxonomies | 174400000X Specialist (Licence: CA CO004912) |
Enumeration Date | 2010-11-30 |
Last Update Date | 2024-01-05 |