NPI | 1326179417 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC49125) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2007-03-08 |
Last Update Date | 2011-02-16 |