NPI | 1326117227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 06-31P) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AR 0631P) |
Enumeration Date | 2006-11-06 |
Last Update Date | 2018-11-19 |