NPI | 1780883058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT130317) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2007-07-16 |
Last Update Date | 2022-05-12 |