| NPI | 1801014428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR TO605) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA RC00057211) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2010-10-19 |