NPI | 1699360537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 202689) |
Enumeration Date | 2021-03-03 |
Last Update Date | 2025-04-09 |