| NPI | 1083756233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1530) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 37978) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-10-04 |