NPI | 1306897798 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS005161L) |
Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: PA PS005161L) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2018-10-09 |