NPI | 1427238708 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC0700X Psychologist, Clinical (Licence: RI PS00793) | |
103TC1900X Psychologist, Counseling | |
103TP2701X Psychologist, Group Psychotherapy | |
103TS0200X Psychologist, School | |
Enumeration Date | 2007-11-05 |
Last Update Date | 2007-11-05 |