NPI | 1104669092 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 149410) |
Additional Taxonomies | 172V00000X Community Health Worker |
Enumeration Date | 2024-06-17 |
Last Update Date | 2024-11-21 |