| NPI | 1023378510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MG61491335) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 107123) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2024-12-23 |