| NPI | 1477039246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60918068) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 3588) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2021-06-03 |