| NPI | 1013949197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0000X Psychologist, Family (Licence: TX 24263) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 24263) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2013-06-24 |