NPI | 1033398284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T0405) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC31395) |
Enumeration Date | 2007-10-24 |
Last Update Date | 2012-02-16 |