NPI | 1003179508 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 85000180A) |
Additional Taxonomies | 172V00000X Community Health Worker |
Enumeration Date | 2012-06-19 |
Last Update Date | 2023-01-25 |