NPI | 1033239090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: CA 52214) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 52214) |
Enumeration Date | 2007-03-30 |
Last Update Date | 2009-02-17 |