| NPI | 1598966426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VT 100.0134001) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 39836) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2024-04-24 |