NPI | 1245590702 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: AR 11-26P) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: TX 35148) |
Enumeration Date | 2012-05-17 |
Last Update Date | 2012-05-17 |