NPI | 1144249996 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 012733) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 12733) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2023-07-05 |