NPI | 1215169156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NV PY0849) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NE 9464) |
103T00000X Psychologist (Licence: NE 847) | |
Enumeration Date | 2009-08-11 |
Last Update Date | 2018-12-03 |