NPI | 1376551291 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 01526) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 1526) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2022-03-01 |