NPI | 1407063530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: DE B1-0000501) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IL 071-004156) |
103TC1900X Psychologist, Counseling (Licence: MD 3572) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2007-07-08 |