NPI | 1336711191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2021-07-12 |
Last Update Date | 2025-05-30 |