NPI | 1639522709 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA PT33159) |
Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: 33159) |
167G00000X Licensed Psychiatric Technician | |
Enumeration Date | 2016-07-13 |
Last Update Date | 2024-08-07 |