NPI | 1184852857 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: TX 34013) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 34013) |
Enumeration Date | 2009-07-01 |
Last Update Date | 2009-07-01 |