| NPI | 1992090245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 201489) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 65667) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2025-01-29 |