NPI | 1508441213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV MI4499) |
Additional Taxonomies | 106S00000X Behavior Technician |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2021-03-15 |
Last Update Date | 2025-04-23 |