| NPI | 1326067810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 201227) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC40138) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-07-08 |