| NPI | 1316179666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KS LP 1980) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: KS LMLP 1300) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2013-07-16 |