NPI | 1073694790 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: RI PS00256) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 3588) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2007-07-09 |