| NPI | 1184888505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1532) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 52774) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2024-01-23 |