| NPI | 1801252150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 9347659-3904) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA AMFT000385) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |