NPI | 1851809867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 143901) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
172V00000X Community Health Worker | |
Enumeration Date | 2018-01-12 |
Last Update Date | 2024-01-09 |