| NPI | 1275952632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF61102709) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001803A) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2023-01-11 |