NPI | 1437990835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: TX 39108) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: TX 39108) |
Enumeration Date | 2024-06-03 |
Last Update Date | 2024-09-24 |