NPI | 1386076446 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS017492) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA TPS030181) |
Enumeration Date | 2013-07-31 |
Last Update Date | 2018-02-02 |