NPI | 1245288067 |
---|---|
Former Name | LEONARD J GOETTL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS009035L) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS009035L) |
103T00000X Psychologist (Licence: WI 263827) | |
Enumeration Date | 2006-05-04 |
Last Update Date | 2020-09-02 |