| NPI | 1356726145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ID LMFT-7872) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF60803645) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2023-06-23 |