NPI | 1558617977 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 82563) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: 82563) |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2012-08-03 |
Last Update Date | 2024-10-18 |