NPI | 1831965599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 38315) |
Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: 38315) |
Enumeration Date | 2023-12-04 |
Last Update Date | 2024-07-15 |