NPI | 1174586697 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: ND 341) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ND 341) |
Enumeration Date | 2006-04-07 |
Last Update Date | 2023-03-01 |