NPI | 1356523716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DE B10000777) |
Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: DE B10000777) |
Enumeration Date | 2007-11-28 |
Last Update Date | 2011-09-15 |