| NPI | 1659438315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00010824) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA RC00047959) |
| 102L00000X Psychoanalyst | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2025-08-30 |