NPI | 1346410446 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: SC 235) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: SC 235) |
Enumeration Date | 2008-03-04 |
Last Update Date | 2008-03-18 |