NPI | 1134790488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PR 7212) |
Additional Taxonomies | 104100000X Social Worker |
104100000X Social Worker (Licence: PR 2120) | |
Enumeration Date | 2021-07-08 |
Last Update Date | 2023-08-29 |