| NPI | 1093394348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 9876235-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 106H00000X Marriage & Family Therapist (Licence: UT 9876235-3904) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2022-11-22 |