| NPI | 1538436795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1876) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC22194) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2024-01-05 |