| NPI | 1851686315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NM 0188121) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF60167047) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2022-07-21 |