| NPI | 1316022528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103TF0000X Psychologist, Family |
| 103T00000X Psychologist (Licence: FL PY 4604) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |