| NPI | 1205449097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 205347) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 128955) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2024-10-10 |