| NPI | 1073651998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 49883) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF61338799) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-11-26 |