NPI | 1316242340 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: HI PSY 1216) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI 1216) |
Enumeration Date | 2011-01-23 |
Last Update Date | 2024-03-13 |