NPI | 1083897425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 372) |
Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: CO 372) |
Enumeration Date | 2007-12-07 |
Last Update Date | 2007-12-07 |