NPI | 1154825065 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 172V00000X Community Health Worker |
390200000X Student in an Organized Health Care Education/Training Program | |
103K00000X Behavior Analyst | |
Enumeration Date | 2018-03-23 |
Last Update Date | 2024-03-05 |