NPI | 1033341748 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NM PSY-2025-0062) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS016663) |
Enumeration Date | 2009-08-13 |
Last Update Date | 2025-07-09 |