| NPI | 1235221383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA 60140895) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 106H00000X Marriage & Family Therapist (Licence: OR T0932) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-03-19 |