NPI | 1144360702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301005940) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801034737) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2007-07-08 |