| NPI | 1699985259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NM CMF0068702) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 4426) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-02-29 |