| NPI | 1750346250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 5889510-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 5889510-3904) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2011-07-07 |