| NPI | 1417281577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3842) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: NC 3842) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2014-03-25 |