NPI | 1992011811 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT88807) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF62082) |
Enumeration Date | 2010-08-30 |
Last Update Date | 2023-08-24 |