NPI | 1144344409 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000781) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS016330) |
Enumeration Date | 2007-03-19 |
Last Update Date | 2009-07-24 |