NPI | 1396849725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301003049) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801018860) |
Enumeration Date | 2006-09-07 |
Last Update Date | 2007-07-08 |