| NPI | 1841398146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 200840395RN) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 34228) |
| 106H00000X Marriage & Family Therapist (Licence: OR TO556) | |
| 163W00000X Registered Nurse (Licence: CA 288983) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-02-23 |