| NPI | 1144479395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 1094-124) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 78952) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2016-09-09 |