NPI | 1477081164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW72767) |
Enumeration Date | 2017-05-25 |
Last Update Date | 2022-07-21 |