NPI | 1003567264 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT143647) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2022-01-10 |
Last Update Date | 2024-01-03 |