| NPI | 1427115195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 201322) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NY 000043) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-09-27 |