| NPI | 1427299643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 1156) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF60064088) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2015-06-12 |