| NPI | 1235453036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60102597) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 1532) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2021-11-04 |