NPI | 1083491732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 142547) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2023-09-14 |
Last Update Date | 2023-11-06 |