| NPI | 1194837500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000183) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DE B10000183) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-02-05 |