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 |