| NPI | 1174043145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 8698654-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 86986543902) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2021-09-07 |