| NPI | 1659582278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC24907) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF00001677) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2007-07-08 |