NPI | 1033493804 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 111223) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2011-09-28 |
Last Update Date | 2019-03-19 |