NPI | 1518382266 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MS T01815) |
Additional Taxonomies | 104100000X Social Worker (Licence: MS w2000) |
Enumeration Date | 2014-03-04 |
Last Update Date | 2024-06-11 |