NPI | 1588977003 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC80610) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2010-07-26 |
Last Update Date | 2015-07-09 |