| NPI | 1235443078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 9124582-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN #1855) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2024-02-06 |