| NPI | 1932867686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 204263) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 114920) |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2021-11-30 |