| NPI | 1043752181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 9132078-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 9132078-3904) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2024-10-03 |