| NPI | 1750529723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 7236803-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 7236803-3904) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2013-10-21 |