| NPI | 1043072945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MG61506078) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 204962) |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-08-05 |