NPI | 1255410247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: WV 202) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: WV 22004) |
Enumeration Date | 2006-11-02 |
Last Update Date | 2008-11-17 |