| NPI | 1356474233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 51534) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF61670026) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2026-03-12 |