| NPI | 1033129689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60692821) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2019-03-06 |