| NPI | 1992466049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 12254209-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 12254209-3904) |
| Enumeration Date | 2021-12-31 |
| Last Update Date | 2022-11-15 |