NPI | 1295581536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT156933) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2024-04-26 |
Last Update Date | 2025-08-05 |