| NPI | 1295959229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 6517282-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 201075) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2011-07-19 |