NPI | 1972074342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF61078528) |
Enumeration Date | 2018-12-11 |
Last Update Date | 2022-12-13 |