NPI | 1205275724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: KS LP2125) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS LP2125) |
103TH0004X Psychologist, Health (Licence: KS LP2125) | |
Enumeration Date | 2013-06-18 |
Last Update Date | 2013-06-18 |