NPI | 1437309259 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 113263) |
Enumeration Date | 2008-09-29 |
Last Update Date | 2022-04-29 |