| NPI | 1346461837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MS T0167) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TN LMT000999) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2016-03-29 |