NPI | 1093932816 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 018193) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY P68794) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2023-07-21 |