NPI | 1285357145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: DC PSYA200001263) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DC LGPC200001720) |
Enumeration Date | 2022-09-26 |
Last Update Date | 2024-03-12 |