NPI | 1427335371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37668) |
Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: TX 37668) |
Enumeration Date | 2011-11-07 |
Last Update Date | 2024-07-24 |