NPI | 1003519463 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV MI4457) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2023-03-24 |
Last Update Date | 2025-02-14 |