NPI | 1295943215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF 00001316) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 33090) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2007-07-08 |