NPI | 1427464536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY004362) |
Additional Taxonomies | 103T00000X Psychologist (Licence: KY 2014-52) |
Enumeration Date | 2014-07-09 |
Last Update Date | 2023-08-20 |