NPI | 1285229989 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 154261) |
Enumeration Date | 2021-03-04 |
Last Update Date | 2025-08-11 |