| NPI | 1720234552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX LPC#8689) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 8689) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2012-04-10 |