| NPI | 1083347710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 11907887-3904) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 11907887-3902) |
| Enumeration Date | 2022-07-09 |
| Last Update Date | 2022-09-13 |