NPI | 1427388859 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS016690) |
Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY61150763) |
Enumeration Date | 2010-01-07 |
Last Update Date | 2021-08-31 |