| NPI | 1477737575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1137) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF60771144) |
| 106H00000X Marriage & Family Therapist (Licence: CA 53307) | |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2024-06-15 |