NPI | 1144453325 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CT 001494) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 6892) |
Enumeration Date | 2009-09-03 |
Last Update Date | 2009-09-03 |