NPI | 1184763229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MS 30447) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MS 30447) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: TN 1381) | |
103T00000X Psychologist (Licence: TN 1381) | |
Enumeration Date | 2007-02-05 |
Last Update Date | 2012-06-06 |