| NPI | 1376798041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T0687) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC32869) |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2016-09-19 |