| NPI | 1740823905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF61067903) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA MG60607295) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2021-08-17 |