| NPI | 1629611892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101007435) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF61496958) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2024-04-16 |