| NPI | 1316011547 |
|---|---|
| Former Name | GUSTAVO R HALLEY JULIA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: NC 6320) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ME PS1194) |
| 103TC0700X Psychologist, Clinical (Licence: PR 02002) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2023-07-14 |