| NPI | 1508178443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60920533) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA MG60116131) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-07-06 |