| NPI | 1962179192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MG61354333) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA MG6135433) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2023-08-30 |