| NPI | 1760405294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 5189) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-02-21 |