NPI | 1093090474 |
---|---|
Former Name | MICHAEL ANDREW HOLSTON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: DE B1-0011487) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS017269) |
Enumeration Date | 2011-10-17 |
Last Update Date | 2025-01-13 |