NPI | 1447842224 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT123045) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2021-02-03 |
Last Update Date | 2022-07-12 |