| NPI | 1346484979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 203629) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC47066) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2022-01-28 |