| NPI | 1366572703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MF20000234) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF00000834) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |