NPI | 1780729343 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR TO128) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L0059) |
Enumeration Date | 2007-02-21 |
Last Update Date | 2025-09-11 |