NPI | 1154474054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: OK 1466) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: OK 1466) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2024-09-25 |