NPI | 1285952978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS018698) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 35SI00605900) |
Enumeration Date | 2010-05-06 |
Last Update Date | 2023-04-21 |