| NPI | 1285189514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 11952129-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 105383) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2020-10-10 |