| NPI | 1376894451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60125319) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 48537) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |