| 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 |