NPI | 1396765780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: OH P.4051) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4051) |
103TC1900X Psychologist, Counseling (Licence: OH 4051) | |
Enumeration Date | 2006-07-20 |
Last Update Date | 2021-01-14 |