| NPI | 1629112214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60209166) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 47390) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-10-30 |