NPI | 1093063539 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TS0200X Psychologist, School |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-2872) |
Enumeration Date | 2012-08-15 |
Last Update Date | 2022-05-27 |